Why You’re So Damn Tired: Uncovering the Truth About Low Testosterone Fatigue
- Dr Rui Graça
- Jun 15
- 2 min read
Updated: Jul 20
By MHI Editorial Team | Medical review: Dr Rui Graça, MD, Urologist & Founder | 15 June 2025
Real case insight:
Ever wondered why you're constantly exhausted despite good sleep? Steve, 38, couldn't understand his relentless fatigue until he discovered the hidden culprit: low testosterone. Learn how fixing one hormone imbalance transformed his energy, mood, and overall health.
Why You’re So Damn Tired: Uncovering the Truth About Low Testosterone Fatigue
Scene 1: The Energy Crash That Wouldn’t Go Away
“Doc, I’ve hit a wall,” Steve admitted to Dr Rui.
“No matter how much I sleep or exercise, I'm always exhausted. It’s dragging down my mood and motivation.”
Dr Rui listened carefully. “Chronic fatigue is common, Steve, but it's not always about rest. Let’s explore further.”
Fatigue affects nearly 40% of men over 35. Often dismissed as lifestyle-related, many overlook low testosterone as the root cause of persistent tiredness, poor mood, and reduced motivation.
Scene 2: Digging Deeper: Libido, Muscle, and Labs
“How’s your libido?” Dr Rui probed. “Any weight changes?”
Steve replied, “Libido’s down, weight’s stable, but hard to keep muscle mass.”
Dr Rui ordered tests to examine Steve's situation in depth:
Total and free testosterone levels
SHBG (sex hormone-binding globulin)
Estrogen levels
Cortisol (stress hormone)
Mini-explainers: Why these tests? Testosterone is crucial for energy, muscle, and mood. SHBG binds testosterone, reducing its effectiveness. Elevated estrogen or cortisol can further complicate symptoms.
Your Next Step: From Guessing to Clarity
If your energy, hormones, or performance feel off, blind guessing won’t cut it.
Start by answering 12 simple questions to uncover your most likely imbalance:
(It’s free, confidential, and gives you an instant self-assessment)
Scene 3: The Hidden Imbalance
Steve's results clarified the issue:
Total Testosterone: Low at 7.5 nmol/L (optimal 10-35 nmol/L)
SHBG: Elevated, binding testosterone excessively
Cortisol: Elevated, indicating chronic stress
Dr Rui explained gently, “Your fatigue stems from low free testosterone and chronic stress. We'll start Testosterone Replacement Therapy (TRT), alongside stress reduction strategies.”
Scene 4: Follow-Up & Estrogen Bump
Initially, Steve improved dramatically, but at eight weeks, he experienced a setback: sudden mood swings and increased fatigue.
New tests showed Steve’s estrogen had unexpectedly risen from 28 pg/mL to 55 pg/mL due to aromatase converting testosterone to estrogen.
“Not uncommon,” Dr Rui reassured. “We’ll introduce a supplement that is also a natural aromatase inhibitor and slightly adjust your TRT dosage.”
Resolution:
By week 12, Steve reported feeling energetic again, with a stable mood and motivation.
His estrogen normalised back to 30 pg/mL, confirming a successful adjustment.
“Finally, I’m not just awake - I’m truly alive,” Steve smiled.
Moral Bullet List: - Persistent fatigue often signals hidden hormonal imbalances. - Low testosterone affects more than libido - it drains energy and motivation. - Hormone therapy should be carefully monitored to manage unexpected shifts (like rising estrogen).
Disclaimer: This article is for educational purposes only and does not constitute medical advice. Consult a licensed physician for personalised care. Clinical details are composite and privacy-protected. Story reviewed by Dr Rui Graça, MD.
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